Does Workers’ Comp Cover Emergency Room Visits?

Suffering an injury on the job in Pennsylvania is stressful. A visit to the emergency room for even the most minor issue can lead to expensive bills that you might not be able to pay. If you suffered this injury while at work, you likely want to know if the visit to the emergency room is covered by workers’ compensation insurance. For the most part, workers’ compensation will cover an emergency room visit in Pennsylvania.

Will Workers’ Comp Cover My ER Bills?

If your injury has been approved by the workers’ compensation insurance company that your employer uses, your ER bills will be covered. However, you will need to go to the ER for your injury within the first 90 days after it happened. If you visit the ER or receive any treatment outside of the 90-day window, workers’ comp might not cover the associated costs. You must also meet the following criteria in order for the costs to be covered by workers’ comp:

  1. Your employer or their workers’ comp provider has approved the treatment, or your claim was approved by a Notice of Compensation Payable.
  2. You are required to visit a panel provider within the first 90 days of suffering the injury if you went to the ER within that 90-day period.

Can I Go to the ER While on Workers’ Comp?

Yes, you can visit the ER while receiving workers’ compensation benefits for a work-related injury. Every injury is different, and there is no telling when you might suffer a setback. For example, you could wake up in the middle of the night to symptoms that have worsened. At this time, your treating physician’s office will be closed. You have no other option but to visit the ER to receive care for your work-related injury. Even though the ER doctor might not be an approved provider by the workers’ comp provider, the bills should still be covered because it was an emergency.

How Long Do I Have to See a Doctor After a Work Injury?

You are required to see a doctor provided by your employer/workers’ comp company for the first 90 days following the injury. Once the 90-day period has expired, you can see any doctor of your choosing for treatment. If your employer does not provide a list of approved doctors for workers’ comp issues, you can seek medical treatment from the doctor of your choosing. Some rules for workers’ comp are as follows:

  • A claim can be denied if you visit a doctor not on the provided list in the first 90 days of suffering the injury.
  • You must provide your employer and workers’ comp insurer monthly reports from the doctor treating you once past the 90-day window.
  • The workers’ comp insurance provider will likely question your decision to see a doctor of your choice, which can make the process daunting and difficult.

What is an Independent Medical Examination (IME)?

You should also note that during recovery/treatment from a work-related injury, an employer or their workers’ comp insurer can request that you undergo an independent medical examination (IME). This request can come at any point during your treatment. The IME will be conducted by a doctor who is different from your personal physician or the workers’ comp doctor you have been seeing.

You are required to attend the IME and could have your benefits stopped if you fail to do so. An IME can be beneficial to you, but for the most part, it can have a major downside. Many IMEs are biased towards the employer, which means the doctor might be more likely to say you have healed from your injury and do not need additional care, therefore ending your workers’ comp benefits.

It is in your best interest to talk to a Philadelphia workers’ comp attorney if you have been requested to undergo an IME by your employer. Having an attorney with you during the IME can ensure that you are not rushed out of medical care.

How to Handle Dissatisfaction With the Care You Receive

If you are dissatisfied with the care you are receiving from the workers’ comp doctor or feel as if you are being rushed to return to work, you should speak with an experienced workers’ comp attorney. An attorney will explain your rights and determine the best legal course of action for your situation.

Call a Philadelphia Workers’ Comp Attorney Today

Did you suffer an injury on the job in Philadelphia? You deserve workers’ compensation benefits from your employer. Talk to a Philadelphia workers’ comp attorney from Krasno Krasno & Onwudinjo about your situation and have the question of whether you can go to the ER on workers’ comp answered. Call our office or submit our contact form to schedule a free consultation today.

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